EAC 2026 - Day 2: #05. Inflammation matters

This is session 5 of the 8th European Aniridia Conference 2026, held in Sofia, Bulgaria, from April 17th to April 19th Session 5: The new perspectives in the treatment of Dry eye Speaker: Prof. Christina Grupcheva, President of the Bulgarian Society of Ophthalmology, Varna, Bulgaria Biopic: Prof. Dr CN Grupcheva, MD, PhD, FEBO, FICO, FIACLE, FBCLA, is a Bulgarian medical doctor, specialist in ophthalmology since 1996. She continued her studies with short fellowships at Moorfields Eye Hospital, London and Dundee University, UK. In 2000, she relocated to New Zealand as a Senior Research Fellow at Auckland University for three years. During that period, she completed a PhD with high commendation and the Best Doctoral Thesis Prize at Auckland University in 2002. She relocated to her home country to serve as a high-level academic and medical director. During her career, she served as a Head of ophthalmology department for 12 years and Vice Recor for 10. She is a corresponding member of the Bulgarian Academy of Sciences and an active member of esteemed learned societies, such as the Academia Ophthalmologica Internationalis, the European Society of Cataract and Refractive Surgery (elected council member), and more. She has published more than 180 scientific papers and 17 ophthalmology books. She has Hi index of 48 and more than 3000 citations. Professor Grupcheva teaches at all graduate and postgraduate levels and has supervised 28 PhD students and 22 residents in ophthalmology. She is the past president of the European Board of Ophthalmology and current President of the Bulgarian Ophthalmological Society. Currently, she serves as TFOS ambassador for Bulgaria. Title of presentation: Inflammation matters Abstract of presentation: Parainflammation plays a critical role in the pathogenesis of dry eye disease (DED) in patients with aniridia, bridging the chronic ocular stress and the development of severe, chronic inflammation (Aniridia-Associated Keratopathy or AAK). Furthermore, the reduction of PAX6 gene function initiates a cascade where the ocular surface loses its ability to maintain homeostasis, shifting to severe inflammatory processes. Parainflammation is characterised as a “protective phenomenon”, but in case of persistence, it becomes harmful. In aniridia, this is triggered by chronic ocular surface stress, including meibomian gland dysfunction (MGD), tear film instability (specifically, high evaporation rates), and limbal stem cell deficiency. Studies show a direct correlation between dry eye severity (measured by tear breakup time, TBUT) and increased levels of inflammatory cytokines (IL-1β, IL-17A, FGF2, and MIP-1α) in the tear fluid of aniridia patients. Parainflammation is heavily implicated in the high prevalence of meibomian gland dysfunction (MGD) in aniridia patients, contributing to evaporative dry eye and furthering the damage to the corneal epithelium. Similar to other chronic DED cases, it is hypothesised that the reduced ability to synthesise cortisol in the corneal epithelium in aniridia weakens the regulatory mechanisms that keep the immune system in check, promoting the progression toward chronic inflammation. Understanding this dysfunctional parainflammatory process is crucial for treating aniridia, as early intervention to reduce inflammation before it develops into full-blown chronic, scarred keratinisation is crucial. Treatments such as Plasma Rich in Growth Factor (PRGF), weaker topical steroids, immunomodulators and other novel molecules can improve ocular surface stability and relieve symptoms of dryness. http://www.aniridiaconference.org | http://www.aniridia.eu